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A Tale of Exquisite Pain

Let me tell you a Tale of Exquisite Pain.

Boquete, Panama. Last week of June, 2011.

This week has been black and white, pleasure and unbelievable circumstance coupled with breathtaking,
shocking pain. Started back at Bocas del Toro, back on Carenero, where the water’s dirty and full of
human shit, I heard say. Heard say once I started paying attention, and dearly did I pay. Started with a
small whitehead, an insignificant little zit like you might catch on your face where fingers stray
out of stress or absent habit, perhaps along the undersides of the jaw in a beardstroking manner,
or along the downlines of the mouth and chin. Little one on my left knee. Popped it out of rhythmic,
natural self-grooming impulse and thought nothing of it, till the next day when it had become larger,
refilled and surrounded by a ring of blushed hot inflammation. Small ring, but I pay at least my body a lot of
attention, and took note. R had just shown up, just appeared lovely into our lives (another
story in and of itself) and we took a walk around the island, a photo excursion that led us through the
swamp of demontrees, those growing in the shallow brackish forest that throw their white roots out and
writhing across the tepid surface. Make for beautiful silent heavy moments, and fine black and whites.

Started getting onery after that. Day later, started smarting, enough to cause concern, so I took off for
the hospital in Bocas, cause I heard that it cost nothing to go there, and because I had consulted the
pharmacists in their shop on the main drag and had made friends of them, meeting respect for our
shared understanding of lightweight antibiotics and the importance of a sound immune system while
being foreign and travelling in a foreign land.

Got to the “hospital” and walked through the broken chainlink gates, stepping over wild clumps of
crabgrass in their ER driveway. A single level, no entrance, no signage; a blinded-windows building on the
edge of town, humorously situated alongside both the retirement home and the cemetery. R was with
me. Chose one of the dingy unlabeled doors and met a confused nurse in a hallway, told me to use
the next door. Back out, next door is locked, but the next yielded a reception. Five or six people, locals
sitting transfixed and in various pitiful states, staring into the overhead television where a show about
most shocking accidents and robberies was playing . One nurse, sitting in white on the opposite side
of the counter asked for my name and passport, which I realized I had foolishly left at the house.
Gave her my name, took a good guess at my passport number (it wasn’t correct) and also told her I was
twenty-three. She took my tempterature by thermometer under the armpit, while R and I talked openly
in English about freezing and panicking when confronted by situations of authority, why I had reverted
to the more familiar answer. Haven’t been asked my age much recently, I guess. Pretty surprised she
would even process me without any identification, actually. Less surprised as I sat and watched the state
of affairs. A young black mother standing and frowning, cradling her infant daughter who first silently
vommed up a clearish liquid to fall the standing distance to the floor, then again. The infant’s worried
brow of concern looking comically mature; her mother idly kicking the sick from her bare foot and flipflop, getting
smart and leaning a bit forward for the consequential jettisons. Then a ten year old boy hobbled in with a large treble hook buried barbs-deep in the ball of his foot, barefoot. No word between anyone of
the Sick on the floor, just looks of pity and mild misery on faces all. Ten minutes pass in heated silence,
the television droning, beconing to its obedient zombies, all of whom happy to be provided any
distraction from the present reality.

Minutes pass and nurse calls my name, I leave R in her plastic orange stadium seat and walk around the
corner to the seeing room. There, a large local woman in a white smock sits and lifts her eyes to
me, and impatient look on her face. I begin to explain to her in my best Spanish about having a bite that
has become infected, regurgitating my friendly pharmacists conversation (his name is douglas) about
the balance between needing to be well, and needing to maintain high immunity while traveling in the tropics. She hears me out and then explains to me that I will have to come back the following morning at six
am to the opposite side of the building, explaining that my case doesn’t merit a visit to the Emergency
Room, and that I will have to take a number and wait in line. When I reiterate what I already know, that I
believe it to be a simple case of antibiotics and Neosporin, she suddenly changes her mind and scribbles
me a prescription for amocyciclin, a mild antibiotic. Mildly offput by the fact that I had just swayed a
professional medical officer in not my mother language, I took the receipt, thanked her and left.

Back in the waiting room, I find R speaking with a man whom I had met before. He’s called Tony, from
Jamaica, tall and Englishspeaking, having lived in Virginia or some such for a number of hears. I explain
to him about the situation, he agrees with me about the alt medicine angle, suggests bathing the bite in
lemon juice or garlic, and then mentions colloidal silver. We immediately bond when I tell him that I am
familiar with it, even have a bottle with me; we say our peace and part in good favor. Walking back to the pharmacy,
R and I stop at the baseball field as the sun is going down. We buy some jungle grapes from an old man
in the street and stroll towards the familiar faces at the pharmacy and I am feeling much better, feeling
that I have communicated effectively and been proactive in handling a medical issue before it took off.
That was maybe five days ago.

Now, dear reader, you find me lying on my back on a rented bed in a hostel in a village called Boquete in
the central, mountainous region of Western Panama. That same left knee and the thigh above it are just
beyond the screen of this laptop, elevated by pillows and yet swollen almost circular, like an elephant’s
leg. Like a tree branch. I’ve no discernable kneecap in sight. What I do have is an infected, abscessed
socket where once lay that lowly pimple, and a swath of hard, angry, reddened flesh that stretches
from the knee down almost to my groin like a colorcoded regional map. It’s wrapped now, professionally
and expediently by Dr. Canadero’s nurse Lubeyka, the same who administered that most hellacious and
incredible procedure some four hours ago when I hobbled down the block for the third day of antibiotic
injections into my ass.

A sentence of backstory: R and I arrived here (me on the Bocas’ prescribed meds) and had not
stepped foot in the hostel (or city, for that matter) more than three minutes, when suddenly a spunky blond German girl named Manya invited us to join her in that night’s
twenty-mile nocturnal trek to the top of Volcan Baru, Panama’s highest point and the central attraction
of Boquete’s adventure outdoors sector. Of course, we jumped at the opportunity, pausing no more
than thirty seconds to consider the worth of sound sleep over a six hour trek to the top of the world, to watch a
tropical sunrise above the cloudforest. A unique, incredible adventure, make no doubt; yet possibly a hasty decision in retrospect. Anyways, we are young and risk-prone, and I’ve never dealt with an
environment of such intense infection potential before (excuse of no precedent, in this court). Also, there’s no clairvoyance here. Who’s to know that all it took to escalate a mild infection to a full scale scary medical emergency might be a single night and day’s hike in dirty pants, coupled with an ill-conceived notion to pop the raised head on the fatigued trip down, thinking that the pain might be alleviated by simply releasing the pressure. It didn’t.
Instead it provoked a sudden and startling exacerbation of the thing, an acceleration to pain, fever and a miserable fearful trip down to the local clinic to get it checked out a day later. (Again.) First thing the nurse said
was, “esta si feo” (yea, that’s ugly).

Anyways, all was stable after a rapidfire Spanish conversation with the very professional and respectable
doctor Candanero, with whom I’ve come to trust and share, when he heard out my story three days
ago. Told me the nurse in Bocas had prescribed me a weaksauce antibiotic in the first place, that yes, it
is always a mistake to reopen an infected wound, and that yes, we will need to keep you for a week of
antibiotic injections and meds. Fine, until this morning when I ambled over in slow motion.

Cadanero was standing large and present in the doorway to the clinic when I came into sight at the
corner. He saw the slow trickle of blood that had made it all the way down to my ankle from the gauze
and bandage at my knee before I even felt it, and immediately shouted for his nurse, ushering me
through the peopled waiting room into the back of his office. They were moving in syncronicity as they
sat me in the room, as Lubeyka propped up my leg, took off the bandage, and immediately spaded both
pointed hands into that most sensitive and hardened flesh immediately around the wound.
I cried out, the pain like a monster.

An abscess, he told me, watching her work. Talking quickly through gritted teeth, cursing in both
languages, I asked them about the procedure that was already well underway. Such incredible, intense,
electric pain like I’ve never experience before in my life, something indescribable. Like grabbing a live
wire and holding. Like pressing the whole of the thing into boiling oil. I have no idea, felt like something
reserved for the battlefield. I found myself shouting out, cursing and swearing in both Spanish and
English, and in tongues. They shouted back to bear the pain, I responded, “Si, puedo hacerlo, pero voy
a gritar tambien!” Fine, they responded, amused. I saw Canadero actually chuckle through his intense
survey of the situation, hovering over his nurse’s shoulders. His laugh became my laugh, and I turned
to see the horror-stricken faces of several small children watching me through a gap in the curtain. Must
have been a nightmare, being a six-year-old sitting in the waiting room and seeing my livid face turn to
meet their eyes; the high, maniacal laughter pouring out, lashing out of me like a madman.

There was nothing else to do! Knew it had to be done, trusting them both, impressed with their concern
and expediency, but goddamn! that pain was like nothing else in my life. Thinking I was just gonna
walk in for a routine injection and being rushed through into the operating room, a sick mix of crimson
and white chunking out of me less than thirty seconds after having crossed the street. Just had to hold
on, the sweat and my pulse thumping right out of me, bullets forming fast and falling heavy from my
forehead.

Couldn’t have been more than three minutes that she pressed the abscess out, but Christ! if I didn’t feel every single one of those seconds go by like a year. Some super-heightened state of awareness, the most awake my
machine is capable of, like a flashbomb, exquisite. She worked the whole area around the now open
wound, forcing the sick out and wiping it clean. Release, drew a full breathe of clean mountain air, then
she fit a blunt-nosed plunger of hydrogen peroxide into the socket and emptied half a vial into this
newly vacated space under the skin. The result was like a science experiment, the one with vinegar and
baking soda in grammarschool. Pink foam billowed up and out of my knee, frothing and building until it
tumbled down my leg, entirely audible in its bubbling cascade. Heinous, I know. You don’t have to read
this. But I’ll be damned if I don’t write it, a fucking Hell of a story and one I’ll be sure not to send home
until the whole thing is healed up and history. It’d make my mother sick to her stomach with worry,
besides the gory description, I’ve no doubt. But there’s no error here, no stretch of the details. Shit was
just ridiculous. And after all that and the peroxide too, Nurse Lubeyka took a pair of polished metal
needle-nosed clamps and began to rather aggressively dab and clean the mouth of the abscess with
a big piece of gauze. This seemed like cake after all that had just transpassed, but then I saw that she
meant to clean deep. “Adentro?!” I asked in disbelief. (Inside?) She met my eyes and confirmed, then
proceeded to force the better part of this four-inch square gauze into the now-empty vacuum under my
kneeskin, telling me that the gauze itself was antibiotic and would help. This was the worst to watch,
seeing the metal tip disappear and nose around under the skin, dragging it’s white net flag behind, but
she was quick about it, and was soon wrapping the whole of the thing up with that stretchy medical
fabric and fluffy clean gauze.

She assured me that the piece under the skin would be the best thing for fighting the infection and that,
by the time I returned tomorrow, I would be feeling much better, the worst already behind. She stood
me up, asked me for the eleven dollar service fee (!!) and sent me on my way. Doc Candanero slapped
me on the shoulder as I went out the front door, telling me to take it easy and that he would see me
again manana.

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